TRT for 3.5 Months - Gyno? Very Worried

Hey guys ive never joined a site before. Ive been reading tons of info here over the past couple of months and on the web and basically anything I can find. Ive had a horrible 1.5 years and was put on trt 3.5 months ago. I tried carefully to not do it all the wrong way but now it seems to be exactly whats happening. I may have found a doc to properly test and monitor me. I also think im going to join defy also. i dont have a ton of cash to spend and have good insurance so was trying to stick with that route. But I think i may be too late and possibly have or developing gynecomastia. Its gonna be a long story and i could use some advice. Im kind of brain dead and mentally exhausted still so ill try to make the story short and just put in the details. Im not really sure where to post so ill just put it here. Thanks in advance.

So i have been feeling horrible for over a year. Im 36 5'9 165lbs. ive been working out my whole life and was always lean but able to bench 315, curl 155 etc. at 155-160lbs. Nov 2015 started feeling totally horrible could barely get out of bed or function. Started seeing my doc. Started gaining weight. Was prob 160 all of a sudden in 2 months was 175 all bad weight. Crazy brain fog, no memory, exhausted, pains all over, dry skin, forehead started and still looks kind of bumpy wrinkly, dry heels, light sensitivity, bad vision at times(still better then 20/20 on eye exam) Right wrist swelled a little for no reason couldnt do one pushup on my hands but could do them on fists. etc. i had a 4.0 in college and perfect memory and started becoming totally retarded, still am, wasn't sleeping, developed apnea(sleep test pending) etc. I do have a c6/c7 issue impinging both sides of nerve root in the past have not had any treatment because emg showed nothing at the time(left tricept and pec were basically dead for a year(2012) got 95 percent of strength and size back. Back to Nov 2015 ...Doc started checking me for lyme disease, rhematoid, blood tests, M.S. test. Ive been to neurologists, spine pain management, neurosurgeons. So everything comes back fine. I think pains are from neck, but the rest i suspected thyroid. Tell them to check it. tsh 3.7, of course they didnt do a full thyroid panel so months later have it retested 3.9. But the antibodies, free t3 t4 are all fine. First test of testosterone was low 400s second test was 330. They refused to bother with the thyroid but agreed to start trt thinking maybe it was the cause. I still think its a thyroid issue as the trt possibly made me feel good for a short time maybe a week. Anyway i had planned to write on here months ago but am so exhausted and cant think straight and am still all over the place with docs. I just paid $1500 for a cash only doctor who seems to be investigating every and any cause of my issues, urine test, crap, blood, iodine, cadmium etc. Everything with him will be gone over in three weeks and im excited.

Thats a quick background So why im posting now is i think i may have gynecomastia developing maybe even too late. Maybe im just being paranoid but something doesnt seem right. I started trt on october 15th 2016 at 200mg/week. First week i did the one shot with the big needle they gave me while i waited for what needles i ordered. First or second week my nipples got really puffed and stuck out further but i thought it was the initial effect and since i had double the test from internal still there and external.From that point on ive done 100mg every monday/friday. nipples went back to normalish but slightly puffy and everything seemed ok in that respect. I told the doc i still felt like crap they said give it time. When it was time for bloodwork and to renew the script (waited till the week before, 11 weeks later) could not get an appointment the phones were not even answered left messages etc. So my last shot was 80mg and then there was a almost two week of nothing until i finally got in. They sent me for bloodwork January 8th 2017 and renewed the script. This whole time im seeing the NP because my lifelong doc takes like a month to see. So she tested my blood for just a couple of things and sensitive estrogen wasnt one of them. Even though i requested. This whole time i feel my estrogen probably skyrocketed and maybe im just paranoid but i told her to check it and she didnt. My test came back i think only 430, maybe from the almost two week break in no shot?

The new $ doc has tested it and everything else and agrees that they arent doing right by me. I will see him thursday this week to go over what tests are back, since all arent and will try to go to the lab tommorow and steal the results early and post them on here. I realise noone can help me without the bloodwork to see whats going on but wanted to get my story out here before im too exhausted to write all this another day as i have tried several times over the past months. It sounds pathetic but I really am that exhausted and braindead even the screen hurts my eyes.

Right now im worried about the gynecomastia while waiting these next couple of weeks to resolve wtf is wrong with me and i think 200/mg per week for me might need an AI or clomid or nolva. Ive never done any juice or anything my whole life so all of this is new to me and although i read tons of things im number one brain dead right now and cant make a decision and number two im flying blind. Im not an idiot and why not take it all in my own hands from the beginning. Because i live in NY where i cant even check my own blood and was going to drive to conneticut and use the online labs but was told they will check my ID upon arrival and reject doing my tests because of the state i live in. Anyway if youve made it this far i greatly appreciate your time. I will post whatever labs i have under this in pdf or a pic with dates. Im not even sure where to get checked for the gyne i tried to go to a walk in clinic to get my estrogen checked and the gyne but theyre all PA's and said its not an emergency and have to see my primary. Should i go to a gyne surgeon to be examined?, ive read xrays and sonos dont even tell you. Ill put a pic up also and maybe you can tell me what you think. Im currently in the worst shape of my life i am back down to 165 but can def lose another 10 of fat and add 10 muscle and i would be back to normal so i dont know if that has any influence in my chest. I havent worked out much the past year due to the issues but my chest was always just more deflated recently seems to be getting bigger. I thought it was maybe the trt adding some muscle as it does seem to be keeping me in decent shape but now i think there is an issue. Again thanks for your time and i appreciate any feedback. I have lots of knowledge now on everything but im not sure what to do with it in this situation. Ive read to act immediately and its a whole other Ai protocol and have no clue what to do or if there even is an issue. Also the doc im seeing is a "consultant " so hes not going to examine me or anything hes just a number and test and logic guy.

200mg/week is definitely too much for a starting dose for trt. At that dosage you are going to run into issues with elevated estradiol. Do you feel a hard lump/nodule and is there any itchiness/soreness? Judging by the pics it looks more like a small lump to the side as oppose to excess fatty tissue.

Rub/pinch around the nipple area and if it feels lumpy/firm it is more than likely developing gyno and if it feels flat/soft like tissue it is more than likely just excess fat.

Thanks for the quick reply. There is no itchyness or soreness in that exact spot but my nipples are a little desensitized from a surgery i had when i was a kid. I did have a little soreness in the upper right side of my chest more up towards my armpit but maybe it was a strain and unrelated. I dont feel any specific hardness but i never had that little fold that just happens to be running from my nipple. Ive never had any body fat but i did gain those 15 pounds in two months then lost ten in a month and havent changed my diet and barely exercised the whole time. I think whatevers going on with me made me gain the weight but then the trt balanced it and made me lose some. Do you think maybe its from that. Im prob 20% body fat right now. Im just worried because if it is and i keep doing what im doing its obviously just gonna proceed worse. I lowered my dose to 80 twice a week but that could actually lower the test level and the estrogen would still be high and create an even better environment for it to happen no? Where would i go get checked for peace of mind any idea? Its just all the docs I deal with lately i just feel like noone ever has a clear answer on anything. What about my level being 430 after 11 weeks on 200/week. Maybe because the two weeks of no shot?

sorry i read that wrong I thought you wrote it looked like excess fat. It all kind of feels the same to me. But if i flex my chest its all rock hard except soft around the nipple area. Ive never really rubbed my own chest in the past to be able to compare it to now. Should that area remain soft

We're glad you joined EM, but I'm afraid to say that you have been victimized by a very poor protocol prescribed by a doctor who isn't in tune with how to manage a patient undergoing androgen replacement. Your post is long and discursive, but I'll try and respond to your major points. Most importantly, for your future health, your determination to seek a new doctor is the right one. I can't speak to your financial situation, but money you invest now in your health is money well spent. Your good insurance is putting your health at risk.

You received an inadequate workup, you were prescribed a protocol at the upper end of TRT, and you have not been properly followed during the weeks you have been injecting testosterone. You had no blood drawn to monitor your response for 11 weeks? It's typical to check it at the six-week mark. Given the significant amount of testosterone you were injecting, 50mg every 3.5 days is a typical, starting dose, it's even more important to check things. If you were injecting on Monday and Friday you weren't on a 3.5 day schedule - which may have spiked your estradiol and/or cleared testosterone from your system so that you experienced the worst of both worlds. We won't know until you have your labs, but it's a potential concern. Two weeks of no testosterone at one point...it's no wonder you don't feel good considering the care you have received. It's a mess.

You may well have gynocomastia - but we aren't doctors. Many men experience nipple sensitivity, and it's usually no worry, when they start TRT, but a good general surgeon can tell you. If you live in a community of any size Google the two terms, "gynocomastia" and "surgeon," along with your place of residence and I'd be astonished if you didn't find some names. We have seen members find treatment a number of times by doing this. It would certainly help out your mind at ease - you're clearly dealing with a lot of anxiety.

Let us know how your labs look, and call Defy tomorrow to start the intake process (or at least discover what the costs are). You deserve so much better than you've received so far.

Thanks for the reply. I had found a surgeon i can have a consult with so ill go there this week or their first available appointment. I have a bunch of questions but ill wait till i get my bloodwork so they are not all what ifs. One thing though. Do you think i should lower my dose to a certain amount in the mean time. Only because i am supposed to pin again tommorow night. I do it every Monday at 9pm and friday at 9am. (1/2" 27g alternating shoulders)Thats what i meant by mon/fr 3.5 days. I went down from the 100 last mon to 80/fri and tomorrow night im not sure what dose i should do? Funny i now sound like all of the stories ive read of exactly what not to do. I hate relying on them to do the bloodwork or wait for appointment i wish i could just do my own labwork at least until i had a stable protocol of where to be.

tc80 said:

Thanks for the reply. I had found a surgeon i can have a consult with so ill go there this week or their first available appointment. I have a bunch of questions but ill wait till i get my bloodwork so they are not all what ifs. One thing though. Do you think i should lower my dose to a certain amount in the mean time. Only because i am supposed to pin again tommorow night. I do it every Monday at 9pm and friday at 9am. (1/2" 27g alternating shoulders)Thats what i meant by mon/fr 3.5 days. I went down from the 100 last mon to 80/fri and tomorrow night im not sure what dose i should do? Funny i now sound like all of the stories ive read of exactly what not to do. I hate relying on them to do the bloodwork or wait for appointment i wish i could just do my own labwork at least until i had a stable protocol of where to be.

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You realize you're moving pieces on the board, your bloodwork, coming back from the tests you'll review this week, is not going to reflect where your levels are at the present time? You have already dropped your dose, I wouldn't drop it again. I would focus on getting the surgical consultation, getting your bloodwork, and finding a new doctor.

You can do your own lab work at least. Go to http://www.discountedlabs.com

I had surgery for gynecomastia on my left pec. It looked a little like your pic. I only had it on one side, but mine was def puffy and centered. I could feel a hard lump under the nipple. It was about the size of a half-dollar, about 1/2 thick. I think yours looks minor. I would not rush into surgery. It could resolve on its own, either with a dose adjustment or change in regimen. I regret having the surgery. Frankly, I was rushed into it before I really had time to process. This was more than 10 years ago, so not as much internet resources to help me. The area around the surgery becomes desensitized ... I'd say it feels dead. It hurt for a long time afterward, and I can still feel some pain if I get pinched or when lifting anything that rubs against my chest.

Your pics looks minor. I would wait it out. The surgery is not without side effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010345/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987263/

I live in NY. We're excluded and can't even buy one and go to a different state because of I.d. Thank you though

Tried to get my labs today but they said said by Friday. I'll post them once I get them. I actually have an appointment with an endocrinologist on Friday do you guys think he would be able to tell me if it is or isn't gyno or do I need a surgeon for that?

tc80 said:

Tried to get my labs today but they said said by Friday. I'll post them once I get them. I actually have an appointment with an endocrinologist on Friday do you guys think he would be able to tell me if it is or isn't gyno or do I need a surgeon for that?

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He should be able to diagnose gyno. In regard to self-testing, you certainly can cross a state line and obtain a blood test through discountedlabs.com. I am a Canadian, cross the border into the US, and have used discountedlabs.com to have blood drawn in Pennsylvania, California, Illinois, Georgia, and Florida. We have members, New Yorkers, who go to PA for blood work.

TC, How about you try a different lab in CT with which to take your self-ordered request?

Another sad example of why federal laws need to be enacted to protect us from the thuggery of the AMA which has its hands dirty in typical NYS back door dealing. Then you have stuff like this going on there:
http://citylimits.org/2015/12/08/nyc-hospital-uses-forced-medication-to-compel-blood-work/

Re-Ride said:

TC, How about you try a different lab in CT with which to take your self-ordered request?

Another sad example of why federal laws need to be enacted to protect us from the thuggery of the AMA which has its hands dirty in typical NYS back door dealing. Then you have stuff like this going on there:
http://citylimits.org/2015/12/08/nyc-hospital-uses-forced-medication-to-compel-blood-work/

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Good advice here. The member here at EM I know who lives in New York goes to Pennsylvania because of proximity, but CT would be an option. You will be asked to present ID, but that's to verify that the name on the lab order matches the person having the test (some report they aren't consistently asked for ID). My Canadian identification doesn't provoke a comment in any of the five states I have used their services.

Thanks for the replies guys. I actually got in contact with DefyMedical and was able to get the sensitive estradiol test done on tuesday Feb 7th (in NY)but havent gotten the results back yet. I did however get my results back from the $$doc and its like 15 pages of blood tests. Im just going to post the first page but if there is anything else that may help me figure this out let me know. I also saw the endocrinologist who was so anti testosterone he didnt want to prescribe me an AI's or anything as he said he would not even fill my testosterone(i dont need him as my primary care does and didnt even ask)I had made that appointment last september before i even stater the Test in october because i suspected thyroid. He didnt feel my chest and i made him take a quick look but he kept just saying "yes breast growth is a common side effect from testosterone". So no answer there. Three surgeons want $300 for a consult and all have a month wait. He also said my Test level is crazy high and looked at me like i was juicing although he did believe my well documented story. He gave me synthroid to try for my thyroid which i will not even begin to play with until getting this under control.

Alright so the facts. Test way too high, E is high(not sure if that is the sensitive test or regular as it does not say sensitive) But my ratio of T to E is so far apart I am suprised i am getting gyno. I know i can lower the T which will probably lower the E. So this was on 100mgx2 a week. I believe the Test 1250 was actually even a day after i was supposed to take a shot so was probably even slightly higher and thats my lowest point. Def gyno going on. Any guidence on what to lower my dose to, how to reverse the gyno, what is causing it(just the 56E?) I ordered letrozole, aromasin, tamoxifen. Its probably not gonna be here for another week. Im basically on my own now as none of these doctors seem to know whats going on but now that i can get some labs done myself maybe i can get things right. Or should i just drop the whole TRT thing and am i just prone to gyno or something. Ive read tons of articles and probably every post on here so sorry for what repetetive but lets just make me one more case and i will keep updating how everything goes after having a plan so maybe it will help someone else in the future. Thanks again for everyones time and i will keep further posts as short as possible.

Im thinking drop test to 60mg 2x a week
2.5 letrozole for 3 days to stop all E activity
After letrozole take aromasin and tamoxifen both for a month as thats what i have read may remove the gyno and let me then come off of them without an etrogen rebound as one is suicidal and the other stops from binding to chest.
the amounts of them i have no clue and if i should stop trt all together after. HELP LOL

Looks like you have serious diet issues, need to clean up your diet and add some supplements.
Are you supplementing with DHEA. dhea will increase E2.

I havent taken any supplements for the last two months. I wanted get all my bloodwork done while not taking any in order to see which ones i really need or dont need as proposed by the wellness doctor i have started seeing.

tc80 said:

Thanks for the replies guys. I actually got in contact with DefyMedical and was able to get the sensitive estradiol test done on tuesday Feb 7th (in NY)but havent gotten the results back yet. I did however get my results back from the $$doc and its like 15 pages of blood tests. Im just going to post the first page but if there is anything else that may help me figure this out let me know. I also saw the endocrinologist who was so anti testosterone he didnt want to prescribe me an AI's or anything as he said he would not even fill my testosterone(i dont need him as my primary care does and didnt even ask)I had made that appointment last september before i even stater the Test in october because i suspected thyroid. He didnt feel my chest and i made him take a quick look but he kept just saying "yes breast growth is a common side effect from testosterone". So no answer there. Three surgeons want $300 for a consult and all have a month wait. He also said my Test level is crazy high and looked at me like i was juicing although he did believe my well documented story. He gave me synthroid to try for my thyroid which i will not even begin to play with until getting this under control.

Alright so the facts. Test way too high, E is high(not sure if that is the sensitive test or regular as it does not say sensitive) But my ratio of T to E is so far apart I am suprised i am getting gyno. I know i can lower the T which will probably lower the E. So this was on 100mgx2 a week. I believe the Test 1250 was actually even a day after i was supposed to take a shot so was probably even slightly higher and thats my lowest point. Def gyno going on. Any guidence on what to lower my dose to, how to reverse the gyno, what is causing it(just the 56E?) I ordered letrozole, aromasin, tamoxifen. Its probably not gonna be here for another week. Im basically on my own now as none of these doctors seem to know whats going on but now that i can get some labs done myself maybe i can get things right. Or should i just drop the whole TRT thing and am i just prone to gyno or something. Ive read tons of articles and probably every post on here so sorry for what repetetive but lets just make me one more case and i will keep updating how everything goes after having a plan so maybe it will help someone else in the future. Thanks again for everyones time and i will keep further posts as short as possible.

Im thinking drop test to 60mg 2x a week
2.5 letrozole for 3 days to stop all E activity
After letrozole take aromasin and tamoxifen both for a month as thats what i have read may remove the gyno and let me then come off of them without an etrogen rebound as one is suicidal and the other stops from binding to chest.
the amounts of them i have no clue and if i should stop trt all together after. HELP LOL

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Can you please post, with ranges, your total and free testosterone values. Also, when we're these taken relative to injection? You are anxious and upset, which makes it a bit hard to follow your narrative. You are also proposing multiple courses of action, some of which will leave potentially leave you in a more precarious position than you currently find yourself.

Thank you.

i take shots 100/mg Friday morning 9am and 100/mg Monday night 9pm. I didnt take my shot Monday night and took this blood test Tuesday morning so 12 hours after my Every three day shot was due.

1-31-17(Tuesday 9am)

Tersosterone 1226 (range 249-836ng/dl)
Free Testosterone 23.28 (range 4.25-30.37pg/ml)
SHBG 19 (range 10-57nmol/L)
Progesterone 0.30 (range <0.16ng/ml)
Estradiol 55.41 ( range 7.02-49.06pg/ml)
PSA 0.62 (range <4.00ng/ml)